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1.
Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement.
Objective
To determine differences in strength and range of motion (ROM) between participants who exhibit medial knee displacement (MKD) during a squat that is corrected by a heel lift and those who do not.Design
Case control.Setting
Sports medicine research laboratory.Participants
Thirty-seven healthy subjects (control, 19; MKD, 18) with no lower-extremity injury in the past 6 months volunteered to participate.Interventions
Not applicable.Main Outcome Measures
Peak force was measured in newtons using a hand-held dynamometer and passive ROM was measured in degrees with a goniometer. Separate multivariate analyses of variance were used to determine differences in strength and ROM between groups. Post hoc testing was used to elucidate differences between groups.Results
The MKD group had the following: greater hip external rotation strength (P=.03), increased hip extension strength (P=.01), less plantarflexion strength (P=.007), and increased hip external rotation ROM (P=.008).Conclusions
The MKD group exhibited tight and weak ankle musculature. Interventions focusing on improving strength and ROM of the ankle may improve kinematics during a squat. 相似文献2.
Paul E. Mintken Joshua A. Cleland Julie M. Whitman Steven Z. George 《Archives of physical medicine and rehabilitation》2010,91(7):1128-1136
Mintken PE, Cleland JA, Whitman JM, George SZ. Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with shoulder pain.
Objective
To investigate the reliability and validity of 2 commonly used measures of pain related fear in patients with shoulder pain.Design
A preplanned secondary analysis of a prospective single-arm trial involving a repeated-measures design.Setting
Outpatient physical therapy clinics.Participants
Patients (N=80) with a primary report of shoulder pain.Intervention
All patients completed the outcome measures at baseline and at follow-up.Main Outcome Measures
Patients completed a modified Fear-Avoidance Beliefs Questionnaire (FABQ), the 11-item version of Tampa Scale of Kinesiophobia (TSK-11), and the Shoulder Pain and Disability Index (SPADI) at baseline and at a 48-hour follow-up. Patients were dichotomized as improved or stable at follow-up based on the Global Rating of Change.Results
Factor analysis indicated 3 stable factors for the FABQ and 1 stable factor for the TSK-11. Shoulder specific scoring for the FABQ and TSK-11 were used in subsequent analyses. Test-retest reliability intraclass correlation coefficient (ICC) was substantial for the FABQ and the TSK-11. The FABQ correlated significantly with SPADI pain and disability scores, while the TSK-11 correlated significantly only with SPADI pain scores. The shoulder-specific FABQ-W (work beliefs subscale) was a better than chance predictor of missing days of work during the 48-hour study period.Conclusions
The modified FABQ and TSK-11 may be appropriate for use in patients with shoulder pain. Shoulder-specific scoring of these measures resulted in substantial test-retest reliability, and the FABQ correlated with the SPADI for pain and disability. The FABQ also showed potential for prediction of short-term work loss in this sample. Pain-related fear may be an important variable in patients with shoulder pain and merits future consideration in longitudinal studies. 相似文献3.
K. Harald Ekedahl Bo Jönsson Richard B. Frobell 《Archives of physical medicine and rehabilitation》2010,91(8):1243-1247
Ekedahl KH, Jönsson B, Frobell RB. Validity of the fingertip-to-floor test and straight leg raising test in patients with acute and subacute low back pain: a comparison by sex and radicular pain.
Objective
To use self-reported disability (Roland-Morris Disability Questionnaire [RMDQ]) to assess the criterion validity of straight leg raising (SLR) test and flexion range of motion (ROM) (fingertip-to-floor test) before and after stratification by sex and presence/absence of radicular pain.Design
Cross-sectional study.Setting
Outpatient physical therapy clinic.Participants
Subjects with acute/subacute low back pain with (n=40) and without (n=35) radicular pain.Interventions
Not applicable.Main Outcome Measures
We examined the relationship between RMDQ (reference variable) and SLR test and fingertip-to-floor test. The sample was stratified by presence/absence of radicular pain (categorized by the dichotomous slump test).Results
In the entire sample, fair correlations were found between both physical impairment tests (ie, SLR test and flexion ROM) and self-reported disability (.27<r>.44). After stratification by sex, the correlation between RMDQ and flexion ROM and between RMDQ and nonside-specific SLR test increased in women but decreased in men. In those with radicular pain, good correlations were found between RMDQ and flexion ROM (r=.68 for men and r=.70 for women), and moderate correlation was found between the RMDQ and SLR tests of the affected side in women (r=.60), but only fair correlation was found between the RMDQ and SLR tests of the affected side in men (r=.28).Conclusions
After stratification by sex and presence/absence of radicular pain, the present study supports a good validity of the fingertip-to-floor test for both men and women with radicular pain. The SLR test, however, was of less value as an indicator of self-reported disability after stratification, especially for men. 相似文献4.
Lin S-I, Lin R-M, Huang L-W. Disability in patients with degenerative lumbar spinal stenosis.
Objective
To determine factors associated with disability in patients with degenerative lumbar spinal stenosis.Design
One-group cross-sectional study.Setting
University hospital.Participants
One hundred eight patients with degenerative lumbar spinal stenosis.Interventions
Not applicable.Main Outcome Measures
Oswestry Disability Index and 4 categories of factors, including patient demographics (age, sex, number of comorbidities, medications), symptom-related factors (intensity, location, onset duration, neurogenic claudication), body structure and function as described in the International Classification of Functioning, Disability and Health model (muscle strength, vibration sense, spine flexibility), and stenotic condition (type and number of spinal segments involved).Results
Patients with symptoms in both back and leg reported greater disability than those with symptoms only in the leg or back (P=.008). Greater disability correlated significantly with greater symptom intensity (r=.385, P<.001) and higher vibration threshold (r=.236, P=.014). While controlling the variance in patient demographics in the regression analysis, vibration sense and symptom location each added 10% of the variance in disability, and symptom intensity and strength each added 5%, with a total of 44% variance explained (P=.044).Conclusions
Symptom intensity and location, vibration sense, and muscle strength were identified as significant factors and, together with patient demographics, accounted for 44% of the variance explained in disability. Further investigations are needed to determine if causal relationships exist between these factors and disability. 相似文献5.
Monga U Garber SL Thornby J Vallbona C Kerrigan AJ Monga TN Zimmermann KP 《Archives of physical medicine and rehabilitation》2007,88(11):1416-1422
Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, Zimmermann KP. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy.
Objective
To show fatigue prevention and quality of life (QOL) improvement from cardiovascular exercise during radiotherapy.Design
Prospective enrollment (n=21), randomized to exercise (n=11) and control groups (n=10), with pre- and post-radiotherapy between- and within-group comparisons.Setting
Academic medical center.Participants
Localized prostate cancer patients undergoing radiotherapy.Interventions
The interventional group received radiotherapy plus aerobic exercise 3 times a week for 8 weeks whereas the control group received radiotherapy without exercise.Main Outcome Measures
Pre- and post-radiotherapy differences in cardiac fitness, fatigue, depression, functional status, physical, social, and functional well-being, leg strength, and flexibility were examined within and between 2 groups.Results
No significant differences existed between 2 groups at pre-radiotherapy assessment. At post-radiotherapy assessment, the exercise group showed significant within group improvements in: cardiac fitness (P<.001), fatigue (P=.02), Functional Assessment of Cancer Therapy-Prostate (FACT-P) (P=.04), physical well-being (P=.002), social well-being (P=.02), flexibility (P=.006), and leg strength (P=.000). Within the control group, there was a significant increase in fatigue score (P=.004) and a decline in social well-being (P<.05) at post-radiotherapy assessment. Between-group differences at post-radiotherapy assessment were significant in cardiac fitness (P=.006), strength (P=.000), flexibility (P<.01), fatigue (P<.001), FACT-P (P=.006), physical well-being (P<.001), social well-being (P=.002), and functional well-being (P=.04).Conclusions
An 8-week cardiovascular exercise program in patients with localized prostate cancer undergoing radiotherapy improved cardiovascular fitness, flexibility, muscle strength, and overall QOL and prevented fatigue. 相似文献6.
Valkeinen H Alén M Häkkinen A Hannonen P Kukkonen-Harjula K Häkkinen K 《Archives of physical medicine and rehabilitation》2008,89(9):1660-1666
Valkeinen H, Alén M, Häkkinen A, Hannonen P, Kukkonen-Harjula K, Häkkinen K. Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial.
Objective
To examine the effectiveness of concurrent strength and endurance training on muscle strength, aerobic and functional performance, and symptoms in postmenopausal women with fibromyalgia (FM).Design
Randomized controlled trial.Setting
Local gym and university research laboratory.Participants
Twenty-six women with FM.Intervention
Progressive and supervised 21-week concurrent strength and endurance training.Main Outcome Measures
Muscle strength of leg extensors, upper extremities, and trunk; peak oxygen uptake (Vo2peak), maximal workload (Wmax), and work time; 10-m walking and 10-step stair-climbing time and self-reported functional capacity (Health Assessment Questionnaire); and symptoms of FM.Results
After concurrent strength and endurance training, the groups differed significantly in Wmax (P=.001), work time (P=.001), concentric leg extension force (P=.043), walking (P=.001) and stair-climbing (P<.001) time, and fatigue (P=.038). The training led to an increase of 10% (P=.004) in Wmax and 13% (P=.004) in work time on the bicycle but no change in Vo2peak.Conclusions
Concurrent strength and endurance training in low to moderate volume improves the muscle strength of leg extensors, Wmax, work time, and functional performance as well as perceived symptoms, fatigue in particular. Concurrent strength and endurance training is beneficial to postmenopausal women with FM without adversities, but more extensive studies are needed to confirm the results. 相似文献7.
Terry S. Horn 《Archives of physical medicine and rehabilitation》2010,91(1):30-34
Horn TS, Yablon SA, Chow JW, Lee JE, Stokic DS. Effect of intrathecal baclofen bolus injection on lower extremity joint range of motion during gait in patients with acquired brain injury.
Objectives
To evaluate lower extremity joint range of motion (ROM) during gait before and after intrathecal baclofen (ITB) bolus administration, and to explore the relation between changes in ROM and concurrent changes in gait speed and muscle hypertonia.Design
Case series.Setting
Tertiary care rehabilitation center.Participants
Adults (N=28) with muscle hypertonia due to stroke, trauma, or anoxia.Interventions
50-μg ITB bolus injection via lumbar puncture (75 and 100μg in 2 cases).Main Outcome Measures
Ashworth score, self-selected gait speed, and sagittal plane ROMs in hip, knee, and ankle joints before and 2, 4, and 6 hours after ITB bolus.Results
A significant decrease in the mean Ashworth score on the more involved side (2.0 to 1.3) and an increase in gait speed (41 to 47cm/s) were noted at different intervals after ITB bolus injection. Ankle ROM significantly increased on the more involved (13° to 15°, P<.01) and less involved (22° to 24°, P<.05) sides. ROM significantly improved, significantly worsened, or showed no significant change in 42%, 34%, and 24% of individual joints, respectively. The peak change in ROM did not coincide with the peak decrease in Ashworth score. Peak changes in ROM and speed coincided more often (P<.001) in participants who increased gait speed after ITB bolus compared with those who decreased speed. The absolute change in ROM after ITB bolus injection correlated better with the concurrent changes in speed (r=.41, P<.001) than with the baseline speed (r=.18, P<.05).Conclusions
ITB bolus injection produces variable changes in joint ROM during gait, with significant improvements in the ankles only. Timing and magnitude of peak changes in ROM are associated with concurrent changes in speed but not muscle hypertonia. 相似文献8.
James M. Elliott Shaun P. O'Leary Barbara Cagnie Gail Durbridge Lieven Danneels Gwendolen Jull 《Archives of physical medicine and rehabilitation》2010,91(9):1418-1422
Elliott JM, O'Leary SP, Cagnie B, Durbridge G, Danneels L, Jull G. Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects.
Objective
To evaluate the activity of neck extensor muscles during different extension exercises with muscle functional magnetic resonance imaging (mfMRI).Design
Cross-sectional.Setting
University laboratory.Participants
Healthy subjects (N=11; 7 men, mean age ± SD, 34±5.6y; 4 women, mean age ± SD, 23.3±5.2y; group mean age ± SD, 30.1±7.5y).Intervention
Not applicable.Main Outcome Measures
mfMRI measures of T2 relaxation were made for the multifidus (Mul), the semispinalis cervicis (SCe), the semispinalis capitis (SCa), and the splenius capitis (SpC) at C2-3, C5-6, and C7-T1 in response to 2 head/neck orientations: craniocervical neutral (CCN) and craniocervical extension (CCE). Subjects performed three 1-minute repetitions of each condition at 20% maximum voluntary contraction.Results
Significant shifts were observed in all muscle groups at the C5-6 and C7-T1 levels after both conditions (P=.04) except the SpC muscle at C5-6 with CCN (P=.17). T2 shifts in the SCa were significantly greater in response to CCE than CCN at C2-3 (P=.03) and C5-6 (P=.02). Similarly, CCE resulted in larger shifts than CCN in the Mul/SCe at C7-T1 (P=.003). No segmental differences were observed between exercises for SpC (P=.25).Conclusions
The results of this study provide some preliminary insight into the impact of craniocervical orientation on the differential response of the deep and superficial cervical extensor muscles during the performance of cervical extensor exercises. 相似文献9.
10.
Su PF Gard SA Lipschutz RD Kuiken TA 《Archives of physical medicine and rehabilitation》2008,89(7):1386-1394
Su P-F, Gard SA, Lipschutz RD, Kuiken TA. Differences in gait characteristics between persons with bilateral transtibial amputations, due to peripheral vascular disease and trauma, and able-bodied ambulators.
Objectives
To examine differences in gait characteristics between persons with bilateral transtibial amputations because of trauma and peripheral vascular disease (PVD); and to compare that with data from able-bodied controls that were previously collected and maintained in a laboratory database.Design
Observational study of persons with bilateral transtibial amputations.Setting
A motion analysis laboratory.Participants
Nineteen bilateral transtibial amputees.Intervention
No experimental intervention was performed. To standardize the effect of prosthetic foot type, subjects were fitted with Seattle Lightfoot II feet 2 weeks before quantitative gait analyses.Main Outcome Measures
Temporospatial, kinematic, and kinetic gait data were recorded and analyzed.Results
Results showed that the freely selected walking speeds of subjects with PVD and trauma were 0.69m/s and 1.11m/s, respectively, while that of able-bodied control subjects was 1.20m/s. When data were compared on the basis of freely selected walking speed, numerous differences were found in temporospatial, kinematic, and kinetic parameters between the PVD and trauma groups. However, when data from similar speeds were compared, the temporospatial, kinematic, and kinetic gait data demonstrated no statistically significant differences between the 2 amputee groups. Although not statistically significant, the PVD group displayed increased knee (P=.09) and hip (P=.06) flexion during the swing phase, whereas the trauma group displayed increased pelvic obliquity (P=.06). These actions were believed to represent different strategies to increase swing phase foot clearance. Also, the PVD group exhibited slightly greater hip power (P=.05) before toe-off.Conclusions
Many of the differences observed in the quantitative gait data between the trauma and PVD groups appeared to be directly associated with their freely selected walking speed; the trauma group walked at significantly faster freely selected speeds than the PVD group. When their walking speeds were matched, both amputee groups displayed similar gait characteristics, with the exception that they might use slightly different strategies to increase foot clearance. 相似文献11.
Gert D. Krischak Anna Krasteva Florian Schneider Florian Gebhard Michael Kramer 《Archives of physical medicine and rehabilitation》2009,90(4):537-1766
Krischak GD, Krasteva A, Schneider F, Gulkin D, Gebhard F, Kramer M. Physiotherapy after volar plating of wrist fractures is effective using a home exercise program.
Objective
To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program.Design
Randomized controlled cohort study.Setting
Hospital-based care, primary center of orthopedic surgery.Participants
Volunteers (N=48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol.Interventions
Not applicable.Main Outcome Measures
Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE).Results
After a 6-week period of postoperative treatment, the patients (n=23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (P=.003), and ROM in extension and flexion 79% (P<.001) of the uninjured side. Ulnar and radial abduction was also higher in this group. In contrast, patients who were treated by a physical therapist achieved grip strength equal to 32%, and ROM in extension and flexion of 52% of the uninjured side. Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50% lower value (P<.001) in the PRWE score.Conclusions
In the postoperative rehabilitation of wrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment. 相似文献12.
Susan B. Williams Caroline A. Brand Keith D. Hill Susan B. Hunt Helen Moran 《Archives of physical medicine and rehabilitation》2010,91(1):106-114
Williams SB, Brand CA, Hill KD, Hunt SB, Moran H. Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study.
Objective
To evaluate the feasibility and gait stability and balance outcomes of a 4-month individualized home exercise program for women with arthritis.Design
Pre-post interventional study.Setting
General community.Participants
Women (N=49) (volunteers) with lower-limb osteoarthritis or lower-limb rheumatoid arthritis were enrolled. Only 39 subjects were eligible and completed the study.Intervention
After completion of the initial assessment, all participants received home balance exercises from an experienced physiotherapist based on assessment findings and exercises available from commercially available kits. All measures were repeated 4 months later.Main Outcome Measures
Falls risk (Falls Risk of Older People—Community Setting) and balance measures.Results
Thirty-nine women (mean age, 69.3y; 95% confidence interval, 65.7-72.9) completed the 4-month program. At baseline, 64% of participants reported falling in the preceding 12 months, and the average falls risk (Falls Risk of Older People—Community Setting) score was 14.5, with 42% rated as moderate risk (16-23). Participants achieved improved performance on most balance and related measures after the exercise program, including falls risk (P=.01), activity levels (P=.015), fear of falling (P=.022), functional reach test (P=.001), rising index for sit to stand (P=.001), step width in walking (P=.001), and body mass index (P=.006).Conclusions
An individualized balance training home exercise program is feasible for older women with osteoarthritis or rheumatoid arthritis and may improve stability during walking and other functional activities. 相似文献13.
Elana Katz Nicole L. Dugan Joy C. Cohn Christina Chu Rebecca G. Smith Kathryn H. Schmitz 《Archives of physical medicine and rehabilitation》2010,91(7):1070-1076
Katz E, Dugan NL, Cohn JC, Chu C, Smith RG, Schmitz KH. Weight lifting in patients with lower-extremity lymphedema secondary to cancer: a pilot and feasibility study.
Objective
To assess the feasibility of recruiting and retaining cancer survivors with lower-limb lymphedema into an exercise intervention study. To develop preliminary estimates regarding the safety and efficacy of this intervention. We hypothesized that progressive weight training would not exacerbate leg swelling and that the intervention would improve functional mobility and quality of life.Design
Before-after pilot study with a duration of 5 months.Setting
University of Pennsylvania.Participants
Cancer survivors with a known diagnosis of lower-limb lymphedema (N=10) were directly referred by University of Pennsylvania clinicians. All 10 participants completed the study.Intervention
Twice weekly slowly progressive weight lifting, supervised for 2 months, unsupervised for 3 months.Main Outcome Measures
The primary outcome was interlimb volume differences as measured by optoelectronic perometry. Additional outcome measures included safety (adverse events), muscle strength, objective physical function, and quality of life.Results
Interlimb volume differences were 44.4% and 45.3% at baseline and 5 months, respectively (pre-post comparison, P=.70). There were 2 unexpected incident cases of cellulitis within the first 2 months. Both resolved with oral antibiotics and complete decongestive therapy by 5 months. Bench and leg press strength increased by 47% and 27% over 5 months (P=.001 and P=.07, respectively). Distance walked in 6 minutes increased by 7% in 5 months (P=.01). No improvement was noted in self-reported quality of life.Conclusions
Recruitment of patients with lower-limb-lymphedema into an exercise program is feasible. Despite some indications that the intervention may be safe (eg, a lack of clinically significant interlimb volume increases over 5mo), the unexpected finding of 2 cellulitic infections among the 10 participants suggests additional study is required before concluding that patients with lower-extremity lymphedema can safely perform weight lifting. 相似文献14.
Astrid M. Horstman Karin H. Gerrits Marijke J. Beltman Peter A. Koppe Thomas W. Janssen Arnold de Haan 《Archives of physical medicine and rehabilitation》2010,91(1):123-128
Horstman AM, Gerrits KH, Beltman MJ, Koppe PA, Janssen, TW, de Haan A. Intrinsic properties of the knee extensor muscles after subacute stroke.
Objective
To characterize muscle properties of paretic lower-limb (PL) and nonparetic lower-limb (NL) knee extensors in patients with subacute stroke.Design
Case-control study.Setting
Rehabilitation center research laboratory.Participants
Patients with subacute stroke (n=14) and able-bodied age-matched control subjects (n=12).Interventions
Not applicable.Main Outcome Measures
Half relaxation times (HRTs) and maximal rates of torque development (MRTDs) were assessed as indicators of contractile speed using both voluntary and electrically evoked contractions. Moreover, changes in torque were measured during a fatigue protocol (35 electrically evoked intermittent contractions; 1.5s on, 2s off) and recovery.Results
No differences among groups were found for normalized MRTDs during electrically evoked contractions (P=.117). However, during voluntary contractions both PLs (53% of control, P=.022) and NL (71% of control, P<.001) had significantly lower MRTD compared with control. Both PL (134% of control, P=.001) and NL (123% of control, P=.032) had significantly higher HRTs than control, indicating muscle slowing in patients with subacute stroke. PLs fatigued more and faster than control (P=.011) and both PL and NL recovered slower (P<.001).Conclusions
The changes in HRTs and fatigue suggest adaptations in muscle properties toward slower, more fatigable muscle shortly after stroke. The inability to make use of contractile speed because of impaired neural activation seems the most limiting factor during the initial phase of torque development in PL. Thus, besides strengthening, muscle endurance and speed should also be addressed during rehabilitation. 相似文献15.
Giuseppe Bellelli Giovanni Buccino Bruno Bernardini Alessandro Padovani Marco Trabucchi 《Archives of physical medicine and rehabilitation》2010,91(10):1489-1964
Bellelli G, Buccino G, Bernardini B, Padovani A, Trabucchi M. Action observation treatment improves recovery of postsurgical orthopedic patients: evidence for a top-down effect?
Objective
To assess whether action observation treatment (AOT) may also improve motor recovery in postsurgical orthopedic patients, in addition to conventional physiotherapy.Design
Randomized controlled trial.Setting
Department of rehabilitation.Participants
Patients (N=60) admitted to our department postorthopedic surgery were randomly assigned to either a case (n=30) or control (n=30) group. Exclusion criteria were age 18 years or younger and 90 years or older, Mini-Mental State Examination score of 21 of 30 or lower, no ambulating order, advanced vision impairment, malignancy, pneumonia, or heart failure.Interventions
All participants underwent conventional physiotherapy. In addition, patients in the case group were asked to observe video clips showing daily actions and to imitate them afterward. Patients in the control group were asked to observe video clips with no motor content and to execute the same actions as patients in the case group afterward. Participants were scored on functional scales at baseline and after treatment by a physician blinded to group assignment.Main Outcomes Measures
Changes in FIM and Tinetti scale scores, and dependence on walking aids.Results
At baseline, groups did not differ in clinical and functional scale scores. After treatment, patients in the case group scored better than patients in the control group (FIM total score, P=.02; FIM motor subscore, P=.001; Tinetti scale score, P=.04); patients in the case group were assigned more frequently to 1 crutch (P=.01).Conclusions
In addition to conventional physiotherapy, AOT is effective in the rehabilitation of postsurgical orthopedic patients. The present results strongly support top-down effects of this treatment in motor recovery, even in nonneurologic patients. 相似文献16.
Sefton JM Hicks-Little CA Hubbard TJ Clemens MG Yengo CM Koceja DM Cordova ML 《Archives of physical medicine and rehabilitation》2008,89(10):1991-1995
Sefton JM, Hicks-Little CA, Hubbard TJ, Clemens MG, Yengo CM, Koceja DM, Cordova ML. Segmental spinal reflex adaptations associated with chronic ankle instability.
Objective
To further understanding of the role that segmental spinal reflexes play in chronic ankle instability (CAI).Design
A 2 × 2 repeated-measures case-control factorial design. The independent variables were ankle group with 2 levels (healthy, CAI) and stance with 2 levels (single, double legged).Setting
University research laboratory.Participants
Twenty-two participants with CAI and 21 matched healthy controls volunteered.Interventions
Not applicable.Main Outcome Measures
The dependent variables were 2 measures of motoneuron pool excitability: paired reflex depression (PRD) and recurrent inhibition.Results
A 2 × 2 repeated-measures multivariate analysis of variance revealed a significant interaction between group and stance on the linear combination of PRD and recurrent inhibition variables (Wilks λ=.808, F2,40=4.77, P=.014). Follow-up univariate F tests revealed an interaction between group and stance on the PRD (F1,41=9.74, P=.003). Follow-up dependent t tests revealed a significant difference between single- and double-legged PRD in the healthy participants (t20=-3.76, P=.001) with no difference in CAI participants (t21=-0.44, P=.67). Finally, there was a significant difference in recurrent inhibition between healthy (mean, 83.66) and CAI (mean, 90.27) (P=.004).Conclusions
This study revealed that, compared with healthy participants, CAI participants were less able to modulate PRD when going from a double- to a single-legged stance. Additionally, CAI participants showed higher overall levels of recurrent inhibition when compared with healthy matched controls. 相似文献17.
Jason Burnett Carmel B. Dyer Aanand D. Naik 《Archives of physical medicine and rehabilitation》2009,90(11):1948-540
Burnett J, Dyer CB, Naik AD. Convergent validation of the Kohlman Evaluation of Living Skills as a screening tool of older adults' ability to live safely and independently in the community.
Objective
To evaluate the convergent validity of the Kohlman Evaluation of Living Skills (KELS) to screen older adults' ability to live safely and independently.Design
Cross-sectional study correlating KELS with components of a Comprehensive Geriatric Assessment.Setting
Participants' homes.Participants
Community-dwelling older adults (N=200) 65 years and older including 100 persons referred by Adult Protective Services (APS) and 100 ambulatory patients matched on age, race, sex, and socioeconomic status.Interventions
In-home comprehensive assessment.Main Outcome Measures
KELS, Geriatric Depression Scale (GDS), modified Physical Performance Test (mPPT), Mini-Mental State Examination (MMSE), Knee Extensor Break Test, Executive Cognitive Test (EXIT25), executive clock-drawing test (CLOX) 1 and 2, and an 8-foot walk test.Results
Older adults with abnormal KELS scores performed significantly worse on all tests except for the Knee Extensor Break Test. Accordingly, among the entire group, the KELS correlated with measures of executive function (EXIT25, r=.705, P<.001; CLOX 1, r=−.629, P<.001), cognitive function (MMSE, r=−.508, P<.001), affect (GDS, r=.318, P<.001), and physical function (mPPT, r=−.472, P<.001) but did not correlate with the Knee Extensor Break Test (r=−.068, P=.456). Among those referred by APS, the KELS failed to correlate with only the 8-foot walk test (r=.175, P=.153) and GDS (r=.080, P=.450).Conclusions
This study demonstrated the convergent validity of KELS with a battery of cognitive, affective, executive, and functional measures often used to determine older adults' ability to live safely and independently in the community. KELS may be a valid and pragmatic alternative to screen for the capacity to live safely and independently among older adults. 相似文献18.
Éimear M. Smith Catherine M. Comiskey Áine M. Carroll 《Archives of physical medicine and rehabilitation》2009,90(7):1127-1135
Smith ÉM, Comiskey CM, Carroll ÁM. A study of bone mineral density in adults with disability.
Objectives
To examine prevalence of low bone mineral density (BMD) among adults with disability, using World Health Organization diagnostic categories.Design
Cross-sectional study.Setting
National Rehabilitation Hospital, Dublin, Ireland.Participants
Patients (N=255; 178 men, 77 women) who were disabled for at least 3 months because of acquired brain injury, spinal cord injury, other neurologic condition, or lower-limb amputation.Interventions
None.Main Outcome Measures
Laboratory investigations including intact parathyroid hormone, 25-hydroxyvitamin D (25-OHD), and sex hormones; and BMD of lumbar spine and at least 1 hip, measured by dual-energy x-ray absorptiometry and expressed as T scores and z scores.Results
Mean age ± SD of participants was 48.7±15.6 years. Vitamin D deficiency, 25-OHD level 50nmol/L or less, occurred in 154 (62.9%); insufficiency, a level between 51 and 72nmol/L, occurred in 36 (14.7%). Based on T scores, 108 participants (42.4%) had osteopenia, and 60 (23.5%) had osteoporosis. A z score of −1 or less but more than −2 occurred in 76 (29.8%); a further 52 (20.4%) had a z score of −2 or less. On multiple linear regression analysis, ambulatory status and duration of disability were independent predictors of BMD at neck of femur (β=.152, P=.007; β=−.191, P=.001, respectively) and total proximal femur (β=.170, P=.001; β=−.216, P<.001, respectively).Conclusions
Osteopenia and osteoporosis are very common in adults with disability participating in rehabilitation, compared with the general young adult population. Duration since onset of disability and mobility status are independent predictors of BMD at the hip. Bone health monitoring should form part of the long-term follow-up in adults with newly acquired disabilities. 相似文献19.
Hopmeier P Puehringer H van Trotsenburg M Atamaniuk J Oberkanins C Dossenbach-Glaninger A 《Clinical biochemistry》2008,41(12):1022-1024
Objectives
We evaluated whether the endothelial protein C receptor (EPCR) haplotypes A1 and A3 exert effects on the development of recurrent pregnancy loss (RPL) in association with factor V Leiden.Design and methods
We determined the EPCR haplotypes A1 and A3 and factor V Leiden in 49 women with a history of RPL and 48 parous controls.Results
In carriers of factor V Leiden the A1 haplotype decreased the relative risk for RPL from 2.2 to 1.0.Conclusions
The EPCR A1 haplotype tends to modulate the risk for RPL in carriers of factor V Leiden. 相似文献20.
Bussmann JB Schrauwen HJ Stam HJ 《Archives of physical medicine and rehabilitation》2008,89(3):430-434
Bussmann JB, Schrauwen HJ, Stam HJ. Daily physical activity and heart rate response in people with a unilateral traumatic transtibial amputation.